The American Legion SYSTEM WORTH SAVING OVERTON BROOKS VA MEDICAL CENTER | SHREVEPORT, LA Date: September 20-21, 2016 Veterans Affairs & Rehabilitation (VA&R) Committee Member: Ricky Griffin Director, Veteran Affairs and Rehabilitation (VA&R) Division:Louis Celli Assistant Director for Health Care: April Commander Overview cal center works collaboratively with the 2nd Medical Group at Barksdale Air Force Base and is a primary receiving center for military casualties in the VA/Department of Defense (DoD) Contingency Plan. The OBVAMC is also Federal Coordinating Center (FCC) for the National Disaster Medical System. Reason for Visit The last System Worth Saving (SWS) site visit to the OBVAMC was April 6, 2006. The American Legion did not identify any challenges during the 2006 site visit. In 2015, the Shreveport Times published an article in the paper stating based on in- formation obtained through a Freedom of Information Act request, 16 percent of Overton Brooks VA Medical Center’s medical positions were unfilled. Of those unfilled positions, 205 in all, 33 positions for physicians were vacant, and 70 nursing positions were unfilled. The Overton Brooks Veteran Affairs Medical Center (OB- The unfilled positions were partly due to complex hiring proce- VAMC) is comprised of one Veterans Health Administration dures and poor recruitment, according to critics of the nation’s (VHA) tertiary care facility and three Community-Based Out- network of 139 hospitals and clinics treating veterans. patient Clinics (CBOCs) serving Veterans in fifteen Louisiana During this visit, the medical center reported only having 44 parishes, five counties in Southern Arkansas and ten counties in vacancies. However, of the vacant positions, 30 positions were East Texas. The medical center is classified as a Clinical Referral for physicians. The total number of staff is 1,682. Level 1C medical center and accepts referrals from the South- east Louisiana Veterans Healthcare System and the Alexandria Each year the OBVAMC completes and submits a Workforce VA Health Science Center. Succession Strategic Plan. A component of the Workforce Suc- cession Strategic Plan is the OBVAMC’s Projected Workforce. The OBVAMC serves over 37,000 Veterans per year. The hos- Their Projected Workforce includes workload projections for pital is accredited for 111 inpatient beds and provides over the next five years. Also outlined in their Projected Workforce 462,000 outpatient visits per year. The medical center has an ac- plan is their ten “hard to fill” positions. Action plans are re- tive accredited research program and is one of the regional sites quired for any position identified as hard to fill and must out- for VISN 16 Hematology/Oncology Center. The medical center line specific objectives and goals to address any hiring delays. manages three CBOCs in Monroe, Louisiana; Longview, Texas; The OBVAMC Workforce Succession Strategic Plan is submit- and Texarkana, Arkansas. ted from Human Resources to the Medical Center Director. The The OBVAMC provides Comprehensive health care through medical director then submits the plan to the VISN where the primary and specialty care in the areas of medicine, surgery, plan in integrated with other VISN facility plans. The compiled psychiatry, physical medicine and rehabilitation, neurology, on- VISN plan in then submitted to VA Central Office (VACO). cology, dentistry, and geriatrics. The Overton Brooks is a teach- ing hospital providing a complete range of patient care services Town Hall Meeting with state-of-the-art technology, as well as education and re- On Monday, September 19, 2016, April Commander moderated search and is affiliated with Louisiana State University School of a town hall meeting regarding concerns of the veterans treated Medicine in Shreveport, State University Health Science Cen- at the OBVAMC. The meeting consisted of a small group of lo- ter, and many allied health schools and universities. The medi- cal veterans and representatives from the offices of Senator Bill The American Legion | SYSTEM WORTH SAVING REPORT 1 The American Legion SYSTEM WORTH SAVING Cassidy, Senator David Vitter, and Congressman John Fleming. the medical center, with one or two stating that “the VA saved Four members of the VA’s executive leadership and staff from my life.” The American Legion National Headquarters, the Department Although a small turnout, the meeting was very productive and of Louisiana, and American Legion Post 14 were also in atten- many left with a sense of relief to know that Legion was there to dance. ensure the VA addressed their concerns. Closing remarks were In keeping with previous town hall meetings, the meeting was made by Commander Rudolph “Rudy” Bourg, Sr. who also ad- held in an open forum to allow all participants the opportunity journed the meeting. to voice their concerns, issues, and comments regarding the medical center. Executive Leadership Briefing The meeting began with a round of introductions, Toby Mathew, On September 20th and 21st, 2016, Veterans Affairs and Reha- director of the medical center, informed the attendees of the bilitation Director Louis Celli, Assistant Director for Healthcare current events taking place at the medical center. He further April Commander and Commission member Rickey Griffin, discussed plans to expand the parking garage upward by two met with the executive leadership team and various depart- floors if there is an ongoing need for more space. The parking ment heads to discuss and address their concerns, challenges garage has increased from 1,400 to 1,600 parking spaces, and and best practices. Executive Leadership staff included Toby the challenges that this presents are the re-striping of the spaces T. Mathew, Medical Center Director; Dr. John Areno, Chief of and redirecting employee parking to the rear of the garage to Staff; Brent Cisler, Interim Assistant Director; Chandra Miller, allow veterans to park closer to the entrance of the facility. Par- Interim Associate Director Patient Care Services; Ruthie Mc- ticipants agreed that parking had been a challenge and that the Daniel, Executive Assistant to Chief of Staff; Brandi Caston, new spaces were a welcomed addition. The further acknowl- Executive Assistant to ADPCS; Kim Lane, Chief Fiscal; Todd edged that the lack of spaces closer to the front of the facility Moore, Chief Quality Services; Jeannie Owens, Patient Safety; was a burden and welcomed the improvement. He then invited Debbie Moradel, Interim Human Resource Officer; Lisa Selmer, questions or concerns from the town hall attendees. Physical Medicine and Rehabilitation Service (PM&RS); Rus- sell Roberts, National Federation of Federal Employees (NFFE) A couple of veterans immediately voiced their issues with the President; and Jean Harp, American Federation Government Posttraumatic Stress Disorder (PTSD) group, and how dissatis- Employees President. fied they were with the new counselor for the group. John stated that the counselor told a military sexual trauma (MST) survivor Access that she could “cure her”. This was very unsettling to the couple as well as the individual involved. John terminated his atten- Executive leadership reported that as of August 2016, the OB- dance with the group. He talked about how very satisfied he was VAMC had an average wait time for primary care patients of with the previous counselor, and how he was dissatisfied with 6.1 days; the average wait time for specialty care patients was the counseling techniques and what he believed to be a lack of 3.8 days; and the average wait time for mental health care pa- empathy on the art of the new counselor. However, the couple tients 14 days. However, they do have same day/walk-in clinic did note improvements in the other services provided by the in both primary care, mental health inpatient and outpatient medical center and after voicing their upset with the counsel- mental health. The average wait time for a veteran in need of ing situation, ended by sharing that they were indeed were quite home health aide or homemaker services is 7-14 days from ini- happy overall with the services at the facility. tial contact to actual services provided. One veteran stated that she was struggling with chronic pain The most significant reasons that impact the medical center’s issues and was very upset during the meeting. Lou Celli, not- ability to schedule veterans’ outpatient appointments promptly ing her apparent discomfort, sought the assistance of Dr. Areno is the difficulty in recruitment of certain specialty providers and (Chief of Staff), who spoke with the veteran privately. She was the unanticipated staff transitions and retirement gaps. Veter- upset and felt that her pain management needs were not met ans waited the longest for physical medicine, rehabilitation, and earlier that day at the emergancy room and appeared to be in supportive employment appointments. distress. Dr. Areno convinced her to leave the town hall and re- Staff Vacancies turn to the medical center’s emergency room while he called ahead to inform them she was enroute. Dr. Areno followed up Human Resources reported the OBVAMC authorized FTE as on her situation the next day. 1,467 of which there are 44 vacancies. Of the current open posi- tions, about 30 are for providers. The VA’s pay scale for physi- Several other veterans shared their positive interactions with cians does not pose a problem, but what does prove problematic The American Legion | SYSTEM WORTH SAVING REPORT 2 The American Legion SYSTEM WORTH SAVING for the recruitment of physicians is the location of the VAMC and their families in a healthy and ethical environment. itself. Inpatient Workload The average number of days that positions are vacant varies between 30 to 910 days. However, OBVAMC completes and • Authorized Beds – 111 submits a yearly Workforce Succession Strategic Plan (WSSP). • Operating Beds – 106 A component of the WSSP is OBVAMC’s Projected Workforce • FY 2015 Admissions - 4,848 (PW).